右美托咪啶超前镇痛对乳腺癌根治术后围拔管期疼痛的影响  

Effect of preemptive analgesia with dexmedetomidine on pain during extubation after radical operation of mastocarcinoma

作　　者：许冬妮[1] 卢桠楠[1] 李金峰[1] 彭书崚[1] 

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广州510120

出　　处：《岭南现代临床外科》2012年第2期147-149,共3页Lingnan Modern Clinics in Surgery

基　　金：国家自然科学基金面上项目(NO.30772091)

摘　　要：目的评价右美托咪啶超前镇痛对乳腺癌保乳根治术术后围拔管期疼痛的影响。方法选择ASAⅠ～Ⅱ级择期在全麻下进行乳腺癌保乳根治术的女性患者42例,随机分为右美托咪啶超前镇痛组和对照组,每组各21例。前者于手术前给予右美托咪啶1μg/kg,后者给予等容量的生理盐水。分别记录手术时间、苏醒时间、拔管时间、围术期血压、心率;观察两组患者术后30分钟内的视觉模拟评分(VAS)和要求追加镇痛药物的时间和剂量以及有无恶心呕吐不良反应。结果 1)右美托咪啶组在围拔管期各时点的VAS评分、需要追加镇痛药物的人次均明显低于对照组;2)使用右美托咪啶患者在围术期心率和血压相较对照稳定;3)两组在拔管时间、恶心呕吐发生率无明显差别。结论右美托咪啶超前镇痛可安全有效地减轻乳腺癌保乳根治术患者的围拔管期疼痛。Objective To investigate the influence of preemptive analgesia with dexmedetomidine on the postoperative pain management during extubation in patients undergoing protective and radical operation of mastocarcinoma. Methods A total of 42 patients aged from 18 years to 65 years, ASAⅠ-Ⅱ, undergoing selective protective and radical operation of mastocarcinoma were randomly divided into dexmedetomidine （D） group and control （n=21,each）. In group D, dexmedetomidine 1 μg/kg were administrated by intravenous injection as preemptive analgesia, and controls were given an equal volume of NS.Heart rate（HR）,mean arterial blood pressure（MAP） were assessed during the anesthesia. The extubation time, waking time, postoperative pain intensity （using VAS score）, the dose and time of analgesic drugs supplement, nausea and vomiting of patients were observed and recorded. Results VAS score and the need of supplementary analgesics were remarkably less in group D than in group C. The HR and MAP in group D were more stable than in group C during peri-operation. No difference was observed of extubation time and side effects between two groups. Conclusion Administration of dexmedetomidine as a preemptive analgesia is effective to mitigate pain during extubation, and not increase the side effects.

关 键 词：右美托咪定 超前镇痛 围拔管期 疼痛 

分 类 号：R614[医药卫生—麻醉学]